The sad thing is, that can be an entirely valid scientific approach, especially in a field where the theoretical underpinning is still uncertain.
Obviously, the initial part of the random testing is animal testing, not human testing. But it really does make some sense to try just about anything, and see what (if anything) does some good.
The science is in its infancy. Call it “alchemy” if you want: mix a little of this and a little of that, and see what happens. Some of the results have been somewhat beneficial.
When it becomes as rigorous as rocket scientist, everyone will celebrate. Until then, “keep banging those rocks together.”
I have no problem with a doctor consulting a brain scan in addition to listening to my self-report of symptoms.
However, I would not trust a doctor who discounted my account in favor of a computer print-out. If my brain scan looks healthy, but I’m reporting a long list of symptoms, how will the doctor handle this? Will I be told medication isn’t right for me? If not, why did I get a brain scan in the first place?
I’d love to be see a scan of my brain and see all of its quirks, just because I’m a self-absorbed nerd. But I’m not so naive as to think every quirk is going to be revealed using any one particular technology. The doctor will still need to do an extensive interview with the patient. He or she will still need to do some guesswork after examining all the data. I don’t want psychiatry to be so simple that anyone who can operate a computer can do it.
Well, if the machine is actually capable of doing the job right and you being are honest* then that simply wouldn’t happen, any more than an X-ray isn’t going to show someone with a dozen broken bones as just fine. If the machine can’t do the job, then it can’t do the job.
*For that matter, such a machine would probably be able to double as an accurate lie detector
You’ve never heard of people with physical symptoms (achy joints, stomach complaints, muscle pains, etc.) but all their scans and blood tests come back negative? And these poor people are often told that there’s nothing wrong with them and told to go see a shrink. Sorry, I’m not really looking forward to the day when shrinks start doing this.
All tests are fallible, because they are devised by fallible creatures. And tests are only as accurate as the knowledge they are based on. A computer scan is only going to pick up on abnormalities that we know about. A brain could be straight-up disordered, but if it’s disordered in a way that the computer hasn’t been trained to see, then the patient will be evaluated incorrectly. And maybe this is a trade-off worth having if it happens infrequently. But let’s not pretend that technology would solve the problem of misdiagnosis.
So how do we get from our current point of understanding, incomplete as it is, to this mystical point in time where we now understand perfectly? You’ve just eliminated the use of the scientific process, so now what?
Nope, they often don’t have exact knowledge of what is best to treat with. There’s a lot of “Well, Patient X had similar symptoms and Drug Y turned out to be best for her, so let’s try that one first.” And when you don’t get a good result with Y, you switch to Z.
What else do you want them to do? Shrug and tell patients, “Go away until we eventually invent that magical diagnostic tool/test mentioned above”?
But this uncertainty isn’t unique to psychiatric treatment. A few months ago my brother ended up in the ER with pneumonia, atrial fibrillation (sp?), and extremely fluctuating blood pressure. He was in the hospital for 11 days. They knocked the pneumonia out in a couple of days. The got his heart beating pretty regularly in about the same time. But they tried various combinations/dosages of EIGHT different drugs before they finally got a combo that mostly kept his blood pressure where it was supposed to be.
BTW, this was at a world renowned Boston hospital and I have no reason to think the doctors were less than excellent.
In treating a mental illness, or really almost any illness I think, there are two determinations that have to be made: is something really wrong, and is it affecting this person’s quality of life? At some point a machine may be able to determine the first one. The second one is ultimately up to the patient. So this is probably not a problem technology can magically solve. The ‘is something really wrong’ issue is maybe more complicated with mental illness because if you think something is wrong with your mind, then there is something wrong. The question is how to deal with it - whether therapy is appropriate, or medication, or some combination or something else. But even a psychosomatic problem is a real mental problem.
I have Crohn’s disease, and that was the gastroenterologist’s approach. First couple of drugs didn’t work, so they iterated until they found something that did. Unless you’re going to tell me Crohn’s disease doesn’t exist either, or is a failure of will, or whatever.
(And autoimmune disease could rather more justifiably be called “poor coping skills” than mental illness).
That’s the standard approach to high blood pressure, diabetes, and high cholesterol, too. People respond differently to different drugs. I’m epileptic and am on the 4th and 5th drugs they tried on me. Mental illness isn’t any different; even with clearcut depression, several different drugs of the same class (usually SSRIs) might need to be trialed.
That’s how it worked with my anti-convulsants – although fortunately the first one worked after trying a second one and then combining the two of them. On the other hand, the very first drug my doctor prescribed for my OCD worked. (Not to mention one of the anti-seizure drugs I take is a lot more expensive than the other two)
If mental illness isn’t organic, or a chemical imbalance, then I’d like to know what the fuck it is.
I haven’t read the thread, but I will point out that you will find almost nobody who will make this argument if they haven’t experienced some form of major mental illness in their life, or if they haven’t had extensive experience with someone who has. It’s a hostile lack of perspective.
Among Liberals: while in general I think you’re right, there is also the slight exceptional possibility of someone making this claim while at the time suffering from a severe mental illness of the type that makes objective assessment of the issue difficult.
(It seems to be a symptom of some kinds of mental illness for the patient to declare, quite fervently, “There’s nothing wrong with me. I’m fine.” Such a person – suffering from other symptoms, so as to qualify by most reasonable standards as ill – might be inspired to deny that mental illness exists at all.)
I didn’t make myself clear, then. I don’t mean that we should stop diagnosing illness and trying to treat it with the tools available at this time until a day comes when we know the brain completely. I meant to say that until that time comes, we’re stuck with the hit or miss system we have now.
You’re quite right. This is oftentimes quite painful and frustrating for family members, who have just gone through traumatic, frightening or sometimes violent incidents with a loved one who still cannot recognize that anything is amiss.
I don’t want to pry too much, but did you eventually overcome the depression or reach a point where you no longer needed to take meds? I ask this because I think it’s inspiring to know that some people might be able to need the meds only for a short time and then do well off of them completely, unlike what I’ve been generally told that you need to be on the drugs for life, no questions asked.
There is some interesting literature I’ve been reading about depression. There’s a theory that a downward spiral kicks in when stress causes a person to brood. Brooding, obsessive thinking leads to serious depression. Take the 90 year old widower I mentioned earlier. He could sit at home and think about how much he misses his wife, hour after hour. He’s doomed. He’s going to become severely depressed. But if he occupies his mind with more healthful thinking, if he doesn’t try to extricate himself from those awful thoughts, that depression can be held at bay.
Easier said than done but very interesting and important nonetheless. I can’t speak for other mental illnesses, since I don’t have personal experience with them, but this should be more mainstream than just whipping out the prescription book so quickly. I’m not saying meds shouldn’t be used at all but just less so than they are now.
Reinforced thought patterns, repeated endlessly. The solution, which one hopes a therapist helps with, is to recognize when you are engaging in a non-productive or destructive thought pattern and break out of it. As simple as “I’m thinking about X again, I need to stop and change the subject”. “As simple as”, but not really all that simple in application. And the counter-process needs to be engaged in every single time the negative pattern re-emerges.
I have chronic clinical depression, but it is usually very mild. From time to time, the depression deepens and I need outside help besides the prozac and xanax that I take for anxiety.
Each time the milder depression deepens into something worse, I don’t recognize it as depression. This has been my experience for fifty years now. I may notice that I don’t concentrate as well or have trouble sleeping, or that I’ve changed my eating habits, but I still don’t recognize it as deepening clinical depression.
There is a reason that I don’t recognize the same illness when it hits me again. The part of the brain that makes judgments is affected by the part of the brain that is the source of depression and vice versa.
That’s why clinical depression isn’t a matter of will power and a good attitude.
Please, please understand this if nothing else: Clinical depression is not just about feeling sad. That’s just one of several symptoms. And the desperation or numbness that you feel may seem to be perfectly appropriate to however you view your life at the time – even when your circumstances may not have changed.